The registered nurse is discussing care of an infant diagnosed with a patent ductus arteriosus (PDA) with a nursing student. The registered nurse determines that the nursing student needs further teaching regarding a PDA when the student states that which circulatory change is a characteristic of this disorder?

A. Cracked lips:
Incorrect: While red, cracked lips are part of the mucous membrane changes seen in Kawasaki disease, they are not specific to the acute stage. Mucous membrane changes can occur in both the acute and subacute stages.
B. Desquamation of the skin:
Incorrect: Desquamation, or peeling of the skin, is more characteristic of the subacute or convalescent stages of Kawasaki disease, particularly on the fingers and toes.
C. Normal appearance:
Incorrect: In the acute stage, the child with Kawasaki disease typically exhibits signs of illness, including fever and other clinical manifestations. A "normal appearance" would not be expected in the acute stage.
D. Conjunctival hyperemia.
Explanation: Conjunctival hyperemia, or redness of the eyes, is a common clinical manifestation of the acute stage of Kawasaki disease. Other typical signs and symptoms during this stage include fever, mucous membrane changes (such as red, cracked lips), changes in the extremities, rash, and cervical lymphadenopathy.

A. Bottle-feed with diluted fruit juice:
Incorrect: Diluted fruit juice is not recommended for infants with diarrhea. Fruit juices, even when diluted, may contain sugars that can exacerbate diarrhea. It's important to focus on water or rehydration solutions.
B. Discontinue breast-feeding until the diarrhea resolves:
Incorrect: Breast milk is an essential source of nutrition for infants, and discontinuing breastfeeding is not recommended, even during episodes of mild diarrhea. Breast milk helps maintain hydration and provides essential nutrients.
C. Provide an increased intake of water.
Correct Answer: Maintaining hydration is crucial during episodes of diarrhea. Offering the infant increased water intake helps prevent dehydration. Rehydration solutions specifically designed for infants can also be recommended.
D. Avoid all solid foods:
Incorrect: While avoiding certain solid foods may be recommended in some cases, it's not necessary to completely avoid all solid foods for a 12-month-old with mild diarrhea. The emphasis should be on maintaining hydration and offering easily digestible foods.